Search PubMed⌕ Search

Biomedical subjects

D Yach

Publications and source records attributed to D Yach.

At least 109 records · Page 6Linked to original sources
PubMed1989

The impact of diarrhoeal disease on childhood deaths in the RSA, 1968-1985.

Diarrhoeal disease remains a major cause of morbidity and mortality in children in the RSA. In 1984, 8,984 deaths from diarrhoea of children under 5 years of age were registered, representing 27.7% of all registered deaths in this age group. Assuming a case/fatality ratio (deaths per 100 episodes of diarrhoea) of 0.6, it is estimated that 1.5 million cases of diarrhoea in children occurred during 1984 in the RSA. Analysis of diarrhoeal disease mortality rates revealed that the group at highest risk is black and coloured children under the age of 1 year. Over the period 1968-1985 there have been steady declines in diarrhoeal disease mortality rates for whites, coloureds and Asians. Uncertainty exists as to the true mortality rate in black children. A marked seasonal cycle is evident in diarrhoeal disease mortality rates for blacks and coloureds with peaks occurring in the period December-March. No seasonal effect on mortality is evident in the white and Asian groups. A nationally co-ordinated diarrhoea control programme is urgently needed in the RSA. This would involve a primary prevention component involving improved water supply, sanitation and sewerage, and a death prevention component emphasising the use of oral rehydration solutions. The seasonality in mortality suggests that the health education component of this programme should be aimed at the period just preceding the summer/autumn epidemic.

Black or African American↗
PubMed1989

Evaluation of a mass measles immunisation campaign in a rapidly growing peri-urban area.

A mass measles immunisation campaign, with a target coverage rate of 85-90%, was launched in Khayelitsha, a rapidly growing urban township in the Cape Town area. Cross-sectional surveys of the measles immunisation status of resident 6-23-month-old infants were conducted immediately before, immediately after, and approximately 2 months after the campaign in order to determine the effectiveness of a mass campaign in boosting coverage in an area with a high influx rate. Immunisation coverage rates were 55% in the first survey, 76% in the second, and 72% in the third. In the first survey, coverage rates for children born in Cape Town were 1.4 times higher than those born elsewhere. This trend continued throughout the survey. Duration of stay in Cape Town also influenced coverage, with rates for the recently arrived children being considerably lower than those for the more established Cape Town residents. The influx rate between the second and third survey (over the Christmas period) was 9.1% per month. Failure to reach the targeted rate is attributed to the influx rate, campaign design and implementation, and factors related to child and career mobility. Alternative immunisation strategies, with social awareness playing a key role, are being urgently investigated.

Cross-Sectional Studies↗
PubMed1989

Smoking practices in the black township population of Cape Town.

A smoking prevalence survey was conducted in the black township population of Cape Town in order to assist with the planning of an anti-smoking campaign. Three townships were selected to reflect different levels of urbanisation: Langa (a settled urban community), Site B (a population of recent arrivals in the urban environment) and Khayelitsha (of intermediate urban status). Using World Health Organisation guidelines a school survey and an adult survey were conducted in each area. Of the 673 school pupils who were interviewed, 0.8% of girls and 23.7% of boys were current smokers. There was a trend to increasing smoking prevalence with increasing age among boys. After age-adjustment there was no difference in smoking prevalence between boys at the three schools. Information from 1320 adult respondents and 1,401 proxy-reported adults yielded an overall smoking prevalence of 7% (95% confidence interval 5.6-8.4%) for women and 60% (95% confidence intervals 57.5-62.5%) for men. Two-thirds of male smokers were smoking 10 or more cigarettes per day. The preferred mode of tobacco consumption in 87% of adults and 91% of school pupils was manufactured cigarettes. The survey has established three target groups for intervention in the black townships of Cape Town: boys in their early teens for prevention of initiation of smoking; adult men for assistance with smoking cessation; and girls and women to maintain their non-smoking status.

Adolescent↗
PubMed1989

Determinants of cigarette smoking in the black township population of Cape Town.

There is concern about the increasing tobacco consumption in developing countries, especially in urban communities. Little information is available on the prevalence and determinants of smoking in black townships in South Africa. We therefore conducted a survey of the smoking practices in three such townships in Cape Town, in which 673 higher primary schoolchildren and 1320 adults were interviewed using a WHO questionnaire translated into Xhosa. Results were analysed using a multiple logistic regression model. In higher primary schoolpupils, boys smoked much more than girls [adjusted odds ratio (ORa) = 17.8; 95% confidence interval (CI): 5.2-60.9]; and smoking prevalence increased with age (ORa = 1.6; 95% CI: 1.3-1.9), peer pressure (ORa = 4.4; 95% CI: 1.9-6.9), and poor health knowledge (ORa = 3.1; 95% CI: 1.6-5.8). In adults, smoking prevalence was 53% in men compared to 6% in women. In men, an urban experience of 6 or more years was significantly associated with smoking (ORa = 1.9; 95% CI: 1.2-3.0) after adjustment for age, health knowledge and occupation. No association was found between level of education and smoking prevalence. Men in higher paid occupations smoked more than those in low paid occupations (ORa = 1.7; 95% CI: 1.0-2.8). Unemployment, however, was not associated with smoking prevalence. The findings emphasise the need for primary prevention of smoking in women and boys. Urbanisation and increased earning power appear to boost tobacco consumption in the absence of active anti-smoking efforts.

Adolescent↗
PubMed1988

Morbidity profile of the Mamre community.

Various morbidity parameters in Mamre, a village of 4,623 residents in the western Cape, are described. Acute morbidity (either injury or illness) occurring in the 2 weeks before the survey was reported by 4% of respondents. Investigation of several chronic conditions for which people said that they were receiving treatment yielded rates of 57/1,000 for hypertension, 29/1,000 for 'nerves', 13/1,000 for diabetes and 19/1,000 for tuberculosis; 9.9% of respondents reported disability. Reported morbidity increased with age, was commoner in women than in men, and agreed with perceptions of individuals' health. Tuberculosis, inadequate sewerage and water facilities, alcohol abuse and dusty roads were perceived to be the main health problems by the community. The morbidity profile and the relatively high rate of pscyhosocial problems found are consistent with a process of urbanisation in a predominantly working-class community.

Adolescent↗
PubMed1988

Mamre Community Health Project--rationale and methods.

The overall aim of the Mamre Community Health Project is to improve the health status of the people of Mamre and to develop an approach to health promotion which may be applicable to other similar areas. Integral to this is the establishment of a surveillance system to monitor changes longitudinally with particular reference to the effects of interventive programmes and the rural-urban transition that the community is experiencing. A multidisciplinary approach that also involves both postgraduate and undergraduate students will be utilised. This article outlines the methodology employed in the first phase of the project, which was concerned with the collection of the baseline data to determine priorities, plan interventions and establish a suitable surveillance system. Approximately 1,000 households were visited and 5,000 residents interviewed by 10 trained interviewers who were selected from the community. Sampling was not used. Methodological issues addressed include the methods used to gain the co-operation and participation of the community, development of an appropriate questionnaire, selection and training of interviewers, supervision of field-work, coding of data and steps taken to ensure the reliability and validity of information collected. Thorough planning with meticulous attention to detail ensured that the Mamre Community Health Project was completed on target with fairly smooth implementation of the data collection phase. Future research will focus on refining epidemiological methods, especially aspects of study design, case definition and exposure status.

Data Collection↗
PubMed1988

Diarrhoea in the Mamre community. A preliminary investigation into aspects of diarrhoea in preschoolers.

Risk factors for diarrhoea in preschoolers in a rural environment on the outskirts of Cape Town were evaluated using the case-control design. Methodological problems limited interpretation. Small sample size affected the precision of the results. Questionnaire-based information has shortcomings for measurement of behavioural risk factors. Despite shortcomings, positive associations with diarrhoea were suggested for use of a bottle during weaning (odds ratio 4.24, 95% confidence intervals 0.48-37.1) and small house size (odds ratio 2.13, 95% confidence intervals 0.34-5.40). Previous diarrhoea was found to be a risk factor for repeated diarrhoea.

Child↗
PubMed1988

Management of hypertension in Mamre women.

A follow-up study was conducted in December 1987 on all 136 women between the ages of 25 and 64 years who had been recorded as being on treatment for hypertension in the Mamre Community Health Project in December 1986. A further 136 women were randomly selected from the same age category to determine the overall prevalence of hypertension. The repeatability and validity of the 1986 project questionnaire were satisfactory. The overall prevalence of hypertension in Mamre women was 25.9% (16.1% for the age group 25-44 years and 38.4% for the age group 44-64 years). The extent of underdiagnosis of hypertension in the community on the basis of the 1986 survey was 56.8%. Despite a good reported compliance rate of 72.7%, 56.3% of hypertensives were not adequately controlled. The Mamre community presents an ideal setting for an interventive study in the management of hypertension.

Adult↗
PubMed1988

Determinants and consequences of alcohol abuse and cigarette consumption in Mamre.

The extent, determinants and consequences of cigarette consumption and alcohol abuse in Mamre are investigated in this article. Among both males and females smoking rates were found to be higher in the 25-44-year-old group than in the 45-64-year group. Males smoked more than females. In the 25-44-year age group a relationship between employment status and smoking as well as between level of education and smoking was established. Odds ratios for smoking of 1,78 for males and 2,42 for females were found in the 25-44-year age group, while odds ratios in the unemployed group were 1,81 for males and 1,79 for females. Alcohol was reported to be a problem in 32.0% of households of which the head was an unskilled manual worker, compared with 9.1% of households of which the head was a professional or a white-collar worker. A positive association was found between alcohol being a problem in the household and the presence of a disabled person in the house, independent of employment status (odds ratio 1,8, 95% confidence interval 1,2-2,5). Respondents who viewed their health as satisfactory or bad were more likely than those with good or excellent health to come from households where alcohol was reported as a problem (odds ratio 1,9, 95% confidence interval 1,4-2,5).

Adult↗